CARIM EYE & RETINA CENTER, LTD. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN
401k plan membership statisitcs for CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN
Measure | Date | Value |
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2022: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 21 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 17 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 17 |
2021: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 32 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 31 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 31 |
2020: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 20 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 32 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 32 |
2019: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-12-01 | 20 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 20 |
Number of retired or separated participants receiving benefits | 2019-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
Total of all active and inactive participants | 2019-12-01 | 20 |
2018: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-12-01 | 22 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 20 |
Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
Total of all active and inactive participants | 2018-12-01 | 20 |
Measure | Date | Value |
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2022 : CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2022 401k financial data |
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Total plan liabilities at end of year | 2022-12-31 | $14,830 |
Total plan liabilities at beginning of year | 2022-12-31 | $16,286 |
Total income from all sources | 2022-12-31 | $222,656 |
Expenses. Total of all expenses incurred | 2022-12-31 | $195,518 |
Benefits paid (including direct rollovers) | 2022-12-31 | $106,017 |
Total plan assets at end of year | 2022-12-31 | $43,954 |
Total plan assets at beginning of year | 2022-12-31 | $18,272 |
Value of fidelity bond covering the plan | 2022-12-31 | $50,000 |
Total contributions received or receivable from participants | 2022-12-31 | $1,300 |
Expenses. Other expenses not covered elsewhere | 2022-12-31 | $88,418 |
Contributions received from other sources (not participants or employers) | 2022-12-31 | $0 |
Other income received | 2022-12-31 | $138 |
Net income (gross income less expenses) | 2022-12-31 | $27,138 |
Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $29,124 |
Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $1,986 |
Total contributions received or receivable from employer(s) | 2022-12-31 | $221,218 |
Value of corrective distributions | 2022-12-31 | $0 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $1,083 |
2021 : CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2021 401k financial data |
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Total plan liabilities at end of year | 2021-12-31 | $16,286 |
Total plan liabilities at beginning of year | 2021-12-31 | $54,990 |
Total income from all sources | 2021-12-31 | $270,494 |
Expenses. Total of all expenses incurred | 2021-12-31 | $245,458 |
Benefits paid (including direct rollovers) | 2021-12-31 | $120,942 |
Total plan assets at end of year | 2021-12-31 | $18,272 |
Total plan assets at beginning of year | 2021-12-31 | $31,940 |
Value of fidelity bond covering the plan | 2021-12-31 | $50,000 |
Total contributions received or receivable from participants | 2021-12-31 | $49,338 |
Expenses. Other expenses not covered elsewhere | 2021-12-31 | $98,704 |
Other income received | 2021-12-31 | $133 |
Net income (gross income less expenses) | 2021-12-31 | $25,036 |
Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $1,986 |
Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $-23,050 |
Total contributions received or receivable from employer(s) | 2021-12-31 | $221,023 |
Value of corrective distributions | 2021-12-31 | $19,089 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $6,723 |
2020 : CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2020 401k financial data |
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Total plan liabilities at end of year | 2020-12-31 | $54,990 |
Total plan liabilities at beginning of year | 2020-12-31 | $15,569 |
Total income from all sources | 2020-12-31 | $247,434 |
Expenses. Total of all expenses incurred | 2020-12-31 | $254,914 |
Benefits paid (including direct rollovers) | 2020-12-31 | $163,494 |
Total plan assets at end of year | 2020-12-31 | $31,941 |
Total plan assets at beginning of year | 2020-12-31 | $0 |
Value of fidelity bond covering the plan | 2020-12-31 | $50,000 |
Total contributions received or receivable from participants | 2020-12-31 | $67,584 |
Expenses. Other expenses not covered elsewhere | 2020-12-31 | $85,583 |
Contributions received from other sources (not participants or employers) | 2020-12-31 | $0 |
Other income received | 2020-12-31 | $120 |
Net income (gross income less expenses) | 2020-12-31 | $-7,480 |
Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $-23,049 |
Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-15,569 |
Total contributions received or receivable from employer(s) | 2020-12-31 | $179,730 |
Value of corrective distributions | 2020-12-31 | $0 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $5,837 |
2019 : CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2019 401k financial data |
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Total plan liabilities at end of year | 2019-12-31 | $15,569 |
Total plan liabilities at beginning of year | 2019-12-31 | $20,681 |
Total income from all sources | 2019-12-31 | $7 |
Expenses. Total of all expenses incurred | 2019-12-31 | $34,237 |
Benefits paid (including direct rollovers) | 2019-12-31 | $34,237 |
Total plan assets at end of year | 2019-12-31 | $0 |
Total plan assets at beginning of year | 2019-12-31 | $39,342 |
Value of fidelity bond covering the plan | 2019-12-31 | $50,000 |
Total contributions received or receivable from participants | 2019-12-31 | $4,976 |
Expenses. Other expenses not covered elsewhere | 2019-12-31 | $640 |
Contributions received from other sources (not participants or employers) | 2019-12-31 | $0 |
Other income received | 2019-12-31 | $7 |
Net income (gross income less expenses) | 2019-12-31 | $-34,230 |
Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $-15,569 |
Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $18,661 |
Total contributions received or receivable from employer(s) | 2019-12-31 | $-4,976 |
Value of corrective distributions | 2019-12-31 | $0 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $-640 |
Total plan liabilities at end of year | 2019-11-30 | $20,681 |
Total income from all sources | 2019-11-30 | $272,309 |
Expenses. Total of all expenses incurred | 2019-11-30 | $253,648 |
Benefits paid (including direct rollovers) | 2019-11-30 | $149,236 |
Total plan assets at end of year | 2019-11-30 | $39,342 |
Value of fidelity bond covering the plan | 2019-11-30 | $50,000 |
Total contributions received or receivable from participants | 2019-11-30 | $67,517 |
Expenses. Other expenses not covered elsewhere | 2019-11-30 | $96,316 |
Contributions received from other sources (not participants or employers) | 2019-11-30 | $0 |
Other income received | 2019-11-30 | $42 |
Net income (gross income less expenses) | 2019-11-30 | $18,661 |
Net plan assets at end of year (total assets less liabilities) | 2019-11-30 | $18,661 |
Net plan assets at beginning of year (total assets less liabilities) | 2019-11-30 | $0 |
Total contributions received or receivable from employer(s) | 2019-11-30 | $204,750 |
Value of corrective distributions | 2019-11-30 | $0 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2019-11-30 | $8,096 |
2022: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | No |
2022-01-01 | This submission is the final filing | No |
2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-01-01 | Plan is a collectively bargained plan | No |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – Trust | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement - Trust | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Submission has been amended | No |
2021-01-01 | This submission is the final filing | No |
2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-01-01 | Plan is a collectively bargained plan | No |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – Trust | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement - Trust | Yes |
2020: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – Trust | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement - Trust | Yes |
2019: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses |
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2019-12-01 | Type of plan entity | Single employer plan |
2019-12-01 | Submission has been amended | No |
2019-12-01 | This submission is the final filing | No |
2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2019-12-01 | Plan is a collectively bargained plan | No |
2019-12-01 | Plan funding arrangement – Insurance | Yes |
2019-12-01 | Plan funding arrangement – Trust | Yes |
2019-12-01 | Plan benefit arrangement – Insurance | Yes |
2019-12-01 | Plan benefit arrangement - Trust | Yes |
2018: CARIM EYE & RETINA CENTER, LTD. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
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2018-12-01 | Type of plan entity | Single employer plan |
2018-12-01 | First time form 5500 has been submitted | Yes |
2018-12-01 | Submission has been amended | No |
2018-12-01 | This submission is the final filing | No |
2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-12-01 | Plan is a collectively bargained plan | No |
2018-12-01 | Plan funding arrangement – Insurance | Yes |
2018-12-01 | Plan funding arrangement – Trust | Yes |
2018-12-01 | Plan benefit arrangement – Insurance | Yes |
2018-12-01 | Plan benefit arrangement - Trust | Yes |
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 169922 |
Policy instance | 5 |
Insurance contract or identification number | 169922 | Number of Individuals Covered | 25 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,668 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $925 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 169922 |
Policy instance | 4 |
Insurance contract or identification number | 169922 | Number of Individuals Covered | 25 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,560 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,211 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,532 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 169922 |
Policy instance | 3 |
Insurance contract or identification number | 169922 | Number of Individuals Covered | 25 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $559 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,569 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $295 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 844665 |
Policy instance | 2 |
Insurance contract or identification number | 844665 | Number of Individuals Covered | 22 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $239 | Total amount of fees paid to insurance company | USD $106 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $239 | Amount paid for insurance broker fees | 106 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 30500387 |
Policy instance | 1 |
Insurance contract or identification number | 30500387 | Number of Individuals Covered | 16 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $77,965 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 595474 |
Policy instance | 3 |
Insurance contract or identification number | 595474 | Number of Individuals Covered | 31 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,777 | Total amount of fees paid to insurance company | USD $254 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $30,206 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $2,529 | Amount paid for insurance broker fees | 254 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 844665000 |
Policy instance | 2 |
Insurance contract or identification number | 844665000 | Number of Individuals Covered | 20 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $407 | Total amount of fees paid to insurance company | USD $86 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,491 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $407 | Amount paid for insurance broker fees | 86 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 30500387 |
Policy instance | 1 |
Insurance contract or identification number | 30500387 | Number of Individuals Covered | 21 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $85,093 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 595474 |
Policy instance | 3 |
Insurance contract or identification number | 595474 | Number of Individuals Covered | 32 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,617 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $26,552 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $3,617 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 844665000 |
Policy instance | 2 |
Insurance contract or identification number | 844665000 | Number of Individuals Covered | 19 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $344 | Total amount of fees paid to insurance company | USD $86 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $8,725 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $344 | Amount paid for insurance broker fees | 86 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | VERIS |
Policy instance | 1 |
Insurance contract or identification number | VERIS | Number of Individuals Covered | 17 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $74,048 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 595474 |
Policy instance | 3 |
Insurance contract or identification number | 595474 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2019-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 844665000 |
Policy instance | 2 |
Insurance contract or identification number | 844665000 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2019-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | VERIS |
Policy instance | 1 |
Insurance contract or identification number | VERIS | Number of Individuals Covered | 20 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2019-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 595474 |
Policy instance | 3 |
Insurance contract or identification number | 595474 | Number of Individuals Covered | 31 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $3,829 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $33,305 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,829 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | VERIS |
Policy instance | 1 |
Insurance contract or identification number | VERIS | Number of Individuals Covered | 20 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $75,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 844665000 |
Policy instance | 2 |
Insurance contract or identification number | 844665000 | Number of Individuals Covered | 0 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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